International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor. Website: www.ijcasereportsandimages.comAn unusual presentation of encapsulating sclerosing peritonitis Emmi Khoo, Dharmenaan Palamuthusingam, Clyson Mutatiri ABSTRACT Introduction: Sclerosing encapsulating peritonitis (SEP) is a rare condition. Underlying cause of SEP is believed to be multifactorial. It can occur secondary to several conditions like prior episodes of severe peritonitis, use of beta-blockers, history of peritoneal dialysis, autoimmune disease, intra-abdominal malignancies, exposure to chemicals such as silicosis or asbestosis, endometriotic cyst, uterine leiomyomas, ovarian tumors, sarcoidosis, or tuberculosis. Case Report: We report an unusual case of a 74-year-old male patient of Dutch descent presented with intermittent watery diarrhea, recurrent ascites and bilateral lower limb lymphedema. Conclusion: Symptoms of the patient at initial presentation were non-specific. Bilateral lower limb lymphedema has not been previously identified in literature as a presenting symptom of this disease. Clinicians need to have a higher index of suspicion for the diagnosis of SEP in those that present with bilateral lower limb lymphedema and non-specific abdominal symptoms. The etiology of SEP in this patient remains unclear, which is consistent with most of the cases reported in literature to date.